title: Future of coagulation factor replacement therapy.
abstract: Over a million patients worldwide currently suffer from hemophilia and other congenital clotting factor deficiencies. Patients affected with hemophilia A and B are treated by intravenous replacement therapy of factor VIII and factor IX, respectively. Current hemophilia treatments have favorably supported their efficacy, tolerability, and safety profiles. The onset of alloantibodies inactivating the infused coagulation factor is the main problem in hemophilia patients rendering replacement therapies ineffective; another disadvantage is the short half-life of the infused clotting factors with the need for multiple and frequent infusions to manage a bleeding episode. Now, the challenge in the management of hemophilia treatment is the prolongation of the half-life and reduction in the immunogenicity of recombinant clotting factors. The bioengineering strategies, previously applied successfully to other therapeutic proteins, encourage the current efforts to produce novel coagulation factors with more prolonged bioavailability, with increased potency and resistance to inactivation and potentially reduced immunogenicity.
authors.affiliation: Angelo Bianchi Bonomi Haemophilia and Thrombosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. flora.peyvandi@unimi.it
authors.forename: F
authors.initials: F
authors.lastname: Peyvandi
authors.forename: I
authors.initials: I
authors.lastname: Garagiola
authors.forename: S
authors.initials: S
authors.lastname: Seregni
mesh_terms: D001709:Biotechnology; D001779:Blood Coagulation Factors / Q000627:therapeutic use*; D006801:Humans
chemical_list: D001779:Blood Coagulation Factors
keywords: factor IX; factor VIII; fusion proteins; half-life; hemophilia; polyethylene glycols; recombinant FVIIa